“My feeling is when the government supports, encourages or facilitates suicide, whether assisted by physicians or otherwise, we devalue our fellow citizens, our fellow human beings,” Mr. Wenstrup said during the press conference at the Longworth House Office Building. “I don’t believe that’s who we should be.”

Dozens of disability rights leaders attended the press conference.

Anita Cameron, the minority outreach director for the disability rights group Not Dead Yet was reportedly stated:

Anita Cameron, minority outreach director for Not Dead Yet, said she has been protesting efforts to repeal Obamacare over the past few days. She said physician-assisted suicide laws only exacerbate the problems with the health care system.

“That kind of ties in with assisted suicide because if you’re taking away health care from people, it’s just that much easier, if assisted suicide also passed, it’s that much easier to recommend prescribed suicide pills for people,” Ms. Cameron said. “And that’s something we don’t want.”

J.J. and Kristen Hanson

Statements on behalf of J.J. Hanson, the President of the Patients Rights Action Fund, were read by his wife Kristen. Hanson has been affected by recent seizures, Hanson stated:

If assisted suicide had been available at the time of his diagnosis, he would have been tempted to end his life, especially during a bout of depression.

“As I wondered, ‘Am I too much of a burden to my family?’ When I asked, ‘Is ending my life easier than this?’ I thought about it, and I considered it,” said Mrs. Hanson, reading for her husband. “Thankfully, I did not end my life, and that is why I am here today.”

CBC News recently reported that Robyn Moro, one of two plaintiffs in a court case challenging the “reasonably foreseeable” death requirement of Canada’s euthanasia law, received a doctor’s assistance to die at the end of August.Ms. Moro had Parkinson’s disease. She was allegedly allergic to many of the pain medications commonly used by people with her condition. Her request for euthanasia was originally denied in March because her doctor did not believe her death was “reasonably foreseeable.”According to the CBC report, Ms. Moro’s doctor (Ellen Wiebe) refused to grant euthanasia requests from patients who were believed to have more than five years to live, based on statistical projections of the life expectancy of the named plaintiff in the Carter case.However, Dr Wiebe changed her mind following an Ontario Superior Court ruling in June of this year in the case of AB v. Attorney General of Canada. In that decision, Judge Paul Perell stated that the “reasonably foreseeable” death standard does not require a person's illness to be terminal. Nor does their death need to be imminent or likely to occur within a given period of time. According to CBC, Dr. Wiebe calculated that AB, the subject of the Ontario Court ruling, might have lived another 10 years. This became her new limit. Since she believed Ms. Moro could not survive that long, Wiebe felt Moro was now eligible for euthanasia. In the AB case, Judge Perell also said “reasonably foreseeable” death applies to a person “who is on a trajectory toward death because he or she:

(a) has a serious and incurable illness, disease or disability; (b) is in an advanced state of irreversible decline in capability; and (c) is enduring physical or psychological suffering that is intolerable and that cannot be relieved under conditions that they consider acceptable.” This could be interpreted to mean that if you satisfy criteria (a) through (c), then your death is reasonably foreseeable.

Even though Ms. Moro has passed away, she will remain a part of the case, assuming the court allows her husband to stand in for her, or relies on Moro’s written statements.The other plaintiff is Julia Lamb, a woman with spinal muscular atrophy living in British Columbia. Although her condition is progressive, it is not terminal. Ms. Lamb is currently able to work part time and live independently with attendant services. However, she is afraid that a sudden decline in her condition will prevent her from breathing and eating independently and using her hands.

There are many reasons to oppose the legalization of assisted suicide and euthanasia. Here are just a few.

It’s Unnecessary – Everyone has the option to commit suicide or to refuse medical care and have palliative sedation on demand.

It’s Discriminatory – While people without disabilities receive suicide prevention services if they express a wish to die, people with disabilities will be encouraged and assisted to kill themselves.

Choice is an illusion – The choice to die cannot be free as long as people with disabilities don’t have the choice in where and how to live.

Safeguards don’t work – Where these practices are legal, safeguards do not prevent people from disabilities from being wrongly killed.

In his second reading speech, Mr Khan initially stressed that the Bill “follows the conservative Oregon model of voluntary assisted dying and not the broader European models of voluntary euthanasia.”

Mr Khan claimed that “The voluntary assisted dying [sic = assisted suicide] scheme in Oregon works. It is a safe and effective framework”. This claim is contentious and cannot be sustained if the albeit limited data from Oregon is carefully scrutinized.

However, later in the speech Mr Khan acknowledged that “Our bill is similar, and also conservative in its approach, but the working group has, in a few key areas of the bill, gone even further than the Oregon model.”

The significant aspects in which the Bill goes further than the Oregon model include the eligibility criteria which extends access to assisted suicide to persons with an “illness that will, in reasonable medical judgment, result in the death of the person suffering from the illness within the next 12 months”. This is substantially different than the Oregon model which only allows access to assisted suicide to persons with “an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months”.

Mr Khan goes on to mention that “certain terminally ill persons may be assisted by their medical practitioners and other qualified health practitioners to administer a substance to themselves”.

This is a very odd, inaccurate and misleading way of describing what the Bill would actually allow. Clause 5 of the Bill includes a provision that “if the patient is physically incapable of self-administering a lethal dose of an authorized substance” a doctor or a nurse may directly administer the lethal dose to the patient.

This provision takes the NSW Bill well beyond the Oregon model which only allows assisted suicide where the person is supposed to self-administer the lethal dose. It takes it well into “the broader European models of voluntary euthanasia”, or in fact, beyond those models by allowing, as a world first, nurses as well as doctors to legally perform euthanasia.

Mr Khan’s Bill, far from being conservative, proposes a very radical approach to assisted suicide and euthanasia.

There is no independent check on a claim that the person is “physically incapable of self-administering”. This is simply arranged between the doctor and the person. This provision makes it more likely that the take up rate in New South Wales will trend towards the European rates where, for example in the Netherlands, If you take out all the sudden deaths like car accidents and heart attacks, more than 1 in 10 (10.5%) of all deaths of 17 to 65 years old are due to euthanasia or assisted suicide, and overall nearly 1 in 20 deaths (4.9%) are the result of assisted suicide or euthanasia.Mr Khan can’t even describe accurately what his Bill allows and attempts to present it as conservative and safe, when it is both radical and dangerous. The people of New South Wales and the MPs who represent them need to carefully examine the actual provisions of the Bill and how they would work in practice before agreeing to exempt doctors and nurses from the current laws prohibiting murder and aiding a suicide.

As usual, instead of seeing in these results a cry of distress from family caregivers of persons with Alzheimer and other dementias, the spotlight is once again focused on euthanasia with its public aura as a solution to suffering. At the same time, it is a real cold shower on all the organisations that accompany with such dedication incapable people and their families. Could we not also infer from this result that only 9 percent of caregivers in Quebec have access to high-quality professional support?

However, before getting carried away by the frenzy of a debate on euthanasia, it would be wise to consider the implications of extending induced death to incapable persons.

First of all, we must recall that the drive for extension of euthanasia to this group was triggered by the high-profile murder of a woman with Alzheimer’s by her husband who “cracked” because he felt left alone. “No one asked me how I’m doing,” he confessed immediately after his act of homicide. Our political decision-makers have turned this murder motivated by desperation into a Trojan horse to promote including a group of extremely vulnerable people among those eligible for medically induced suicide.

In the event of this extension of euthanasia being accepted – less than two years after the law came into force – two “safeguards” that were deemed fundamental at the outset would automatically fall: decision-making capacity and consent to choose death.

Nothing less.

Moreover, in the depth of the current debates, a dramatic message hides behind the possibility of extending euthanasia to people who are no longer able to make their own decisions. Presumably, these people would no longer be fully considered as human beings.

Indeed, their will to live at the moment of their killing would no longer have to be respected, under the pretext of their having written an advance directive in the past. Therefore, it is not a question of consenting or refusing consent to medical care in the event of incapacity – as is the case with the advanced medical directives that are already legal in Quebec. Rather, it is a matter of allowing a person to kill someone who is unable to consent, even when there is no question of artificial life support.

The difference is essential.

In such circumstances, it would be legally – and appear to be morally – possible to explain to them that they are no more than the shadow of a real person who is somehow already dead and who put in writing, in their “true lifetime”, that they would like us to kill them if they became incapable. “You no longer agree? You seem happy now? It does not change anything, you cannot change your mind. Your will to live no longer counts,” we would answer them. “What matters is the document you signed when you were a real person, saying that you must now be put to death. Yes, putting you to death are the exact words since you are in such a vulnerable state that you have become incapable of making an informed decision about yourself or your property. This is the definition of incapacity.”

Thus, by denying their right and even their desire to live, people living with a form of dementia will be implicitly regarded as sub-human beings who will inevitably have to bow to the will of their "former self".

Moreover, this scenario is not some kind of scarecrow. It is not at all hypothetical since we had a concrete example recently in the Netherlands, where a woman with dementia was euthanized against her will. Moreover, the possibility of such a turn of events is reinforced by another result of the Université de Sherbrooke's poll, which reveals that 72 percent of respondents were in favour of euthanasia “even in the absence of a written directive".

Of course, the suffering of family caregivers is very real, but their reaction stems largely from the woeful lack of support for the majority of the people affected by this type of disease. As serious and revealing as it may seem, it has unfortunately become common to hear that death is preferable to life in a CHSLD (nursing home). It seems to me that this would be a good starting point for tackling the problem at the source...

Meanwhile, the dangerous tangent that legal euthanasia installs in every society that has endorsed it continues fatefully its advance in Quebec. It is insinuating into our collective thinking the notion that death – not good health care, quality support and adequate living conditions – is a solution to suffering for you and your loved ones. In the current debate, the logic inherent in assisted suicide now plunges another condition of life into disgrace, such that the death of the people who live with it is presented as preferable.

Yet, in a promotional trailer about the Carpe Diem approach, Ms. Blandine Prévost, 38, suffering from Alzheimer's disease, perfectly sums up the human alternative that should be advocated: "It is in changing the way we are seen by people that lies the hope that I can be a person right to the end."

In other words, beyond debates on euthanasia, it seems therefore urgent to ask ourselves, as a society, how we consider people who have rendered incapable because of illness. Do we still grant them their full humanity?

“Protecting the vulnerable and providing quality care for all patients are cornerstones of any good healthcare system. Included in that is providing comfort and care for those facing the heart-wrenching challenges of dealing with a potentially terminal illness. In some cases, this commitment to fighting for the best care – even in the face of the most deadly diseases – can result in new and innovative cures, offering the chance of recovery for both the patient and for others suffering in the future. In other cases, it is simply a question of offering end-of-life comfort and support.

Physician-assisted suicide, however, does the opposite. It undermines a key safeguard that protects our nation’s most vulnerable citizens, including the elderly, people with disabilities, and people experiencing psychiatric diagnoses. Americans deserve better.

We will continue to defend every human being’s inherent dignity, and work to ensure patients facing the end of their lives have access to the best quality and most comprehensive medical care possible, including palliative, in-home, or hospice care, tailored to their individual needs. When governments support, encourage, or facilitate suicide – whether assisted by physicians or others – we devalue our fellow citizens, our fellow human beings. That should not be who we are."

Nonpartisan patients’ rights and disability rights advocacy organizations across the country have spoken out in strong support of this bipartisan resolution, including:

Patients Rights Action Fund:

“Many do not realize that people battling terminal illness, people with disabilities and others are inadvertently targeted by the legalization of assisted suicide. I am grateful to Congressmen Correa, Vargas, Wenstrup and all of the other cosponsors for introducing this Sense of Congress resolution,” said J.J. Hanson, President and a terminal brain cancer patient. “This bill brings attention to this important issue and takes a big step toward protecting me and so many others from a death-too-soon.”

National Council on Independent Living:

“Our society places a high value on physical appearance and ability, and stigmatizes significant disability. It's no surprise that those of us who grew up able-bodied and then became disabled might initially see disability as a huge loss of one’s former dreams and physical abilities,” said Kelly Buckland, Executive Director. “When someone is first hit with this, they may feel they’d be better off dead. As one struggles to get basic needs met, some people feel worn down. If assisted suicide had been legal in the past, even if it were supposedly only for those with “terminal” conditions, I might not be here today. I’m grateful that assisted suicide was not legal back then, and I'm committed to keeping it that way. This is an important reason why the National Council on Independent Living opposes assisted suicide laws. NCIL is a leader in the disability rights movement, our political struggle for equal rights. And, among other things, equal rights include equal suicide prevention.”

Disability Rights Education & Defense Fund (DREDF):

“Where assisted suicide is legal, some people’s lives will be ended without their consent, through mistakes and abuse. No safeguards have ever been enacted or even proposed that can prevent this outcome, which can never be undone,” said Marilyn Golden, Senior Policy Analyst. “The so-called safeguards are very weak, and the lack of oversight hides these dangers from public view. Moreover, assisted suicide laws are a prescription for elder abuse and abuse of people with disabilities. Supporters of assisted suicide say such laws won’t affect disabled people—but they will, whether or not they realize it. But there is a legal alternative: anyone dying in discomfort may legally receive palliative sedation. Under these circumstances, assisted suicide is not real choice, but a phony form of freedom.”

ADAPT:

“Disabled people and seniors who need assistance with everyday tasks like dressing and bathing want the choice to get those services at home and to have control over how they’re delivered. We do not want to be forced into a nursing facility, nor forced to live in poverty to qualify. Unfortunately, that choice is not a reality for most of us. In states that have legalized assisted suicide, Oregon data shows, over a third of those who request assistance to die do so because of “feelings of being a burden” and over 90% cite “loss of autonomy” as a factor,” said Stephanie Woodward, Director of Advocacy. “If the only alternative to death is poverty and segregation in nursing facilities, assisted suicide is not a “choice.” Society is failing to ensure access to consumer controlled long-term services. The last thing we need in this time of draconian budget cuts in Medicaid is the legalization of assisted suicide laws, because the untimely deaths of disabled Americans can easily be seen as a cost saving answer.

Not Dead Yet:

"As a national, secular, social justice organization, Not Dead Yet strongly supports this bipartisan effort to speak truth to the many myths about legalized assisted suicide," said Diane Coleman, President/CEO. "As Americans with disabilities, we are on the front lines of the nation's health care system that often devalues old, ill, and disabled people. So we are grateful for this Sense of Congress that explains the dangers of mistake, coercion, and abuse under a public policy of assisted suicide."

Physicians for Compassionate Care Education Fund:

"Empowering doctors to assist patients in killing themselves has led to an inevitable erosion of trust in the motives of doctors, health care institutions, and insurers. This has been detrimental to patients, degraded the quality of medical care, and compromised the integrity of medical profession wherever assisted suicide has been legalized,” Dr. William F. Toffler, National Director. “The solution to suffering is not to end the life of the sufferer; rather society's focus at the end of life should be to alleviate suffering by improving access to hospice and palliative care whenever it is needed."

The Euthanasia Prevention Coalition supports H. Con. Res. 80 and we hope that the resolution will open the doors to a new awareness of how assisted suicide laws are designed to protect doctors who prescribe lethal drugs to their patients and eliminate, not provide choice. Link to the official Text - H. Con. Res. 80.

Link to the official Text - H. Con. Res. 80.Expressing the sense of the Congress that assisted suicide (sometimes referred to as death with dignity, end-of-life options, aid-in-dying, or similar phrases) puts everyone, including those most vulnerable, at risk of deadly harm and undermines the integrity of the health care system.

Expressing the sense of the Congress that assisted suicide (sometimes referred to as death with dignity, end-of-life options, aid-in-dying, or similar phrases) puts everyone, including those most vulnerable, at risk of deadly harm and undermines the integrity of the health care system.

Whereas “suicide” means the act of intentionally ending one’s own life, preempting death from disease, accident, injury, age, or other condition;

Whereas “assisting in a suicide” means knowingly and willingly prescribing, providing, dispensing, or distributing to an individual a substance, device, or other means that, if taken, used, ingested, or administered as directed, expected, or instructed, will, with reasonable medical certainty, result in the death of the individual, preempting death from disease, accident, injury, age, or other condition;

Whereas society has a longstanding policy of supporting suicide prevention such as through the efforts of many public and private suicide prevention programs, the benefits of which could be denied under a public policy of assisted suicide;

Whereas assisted suicide most directly threatens the lives of people who are elderly, experience depression, have a disability, or are subject to emotional or financial pressure to end their lives;

Whereas the Oregon Health Authority’s annual reports reveal that pain or the fear of pain is listed second to last (25 percent) among the reasons cited by all patients seeking lethal drugs since 1998, while the top five reasons cited are psychological and social concerns: “losing autonomy” (92 percent), “less able to engage in activities that make life enjoyable” (90 percent), “loss of dignity” (79 percent), “losing control of bodily functions” (48 percent), and “burden on family friends/caregivers” (41 percent);

Whereas the United States Supreme Court has ruled twice (in Washington v. Glucksberg and Vacco v. Quill) that there is no constitutional right to assisted suicide, that the Government has a legitimate interest in prohibiting assisted suicide, and that such prohibitions rationally relate to “protecting the vulnerable from coercion” and “protecting disabled and terminally ill people from prejudice, negative and inaccurate stereotypes, and ‘societal indifference;’”

Whereas clearly expressing that assisted suicide is not a legitimate health care service, Congress passed, with a nearly unanimous vote, and President Bill Clinton signed, the Assisted Suicide Funding Restriction Act to prevent the use of Federal funds for any item or service, including advocacy, provided for the purpose of causing, or assisting in causing, the death of any individual such as by assisted suicide, euthanasia, or mercy killing;

Whereas a handful of States have authorized assisted suicide, but over 30 States have rejected over 200 attempts at legalization since 1994;

Whereas States that authorize assisted suicide for terminally ill patients do not require that such patients receive psychological screening or treatment, though studies show that the overwhelming majority of patients contemplating suicide experience depression;

Whereas the laws of such States contain no requirement for a medical attendant to be present at the time the lethal dose is taken, used, ingested, or administered to intervene in the event of medical complications;

Whereas such State laws contain no requirement that a qualified monitor be present to assure that the patient is knowingly and voluntarily taking, using, ingesting, or administering the lethal dose;

Whereas such State laws contain no requirement to secure lethal medication if unwanted or if death occurs before such medication is used;

Whereas such State laws do not prevent family members, heirs, or health care providers from pressuring patients to request assisted suicide;

Whereas such States qualify some patients for assisted suicide by using a broad definition of “terminal disease” and “going to die in six months or less” that includes diseases (such as diabetes or HIV) that, if appropriately treated, would not otherwise result in death within six months;

Whereas it is extremely difficult even for the most experienced doctors to accurately prognosticate a six-month life expectancy as required, making such a prognosis a prediction, not a certainty;

Whereas reporting requirements vary by State, but when required, rely on prescribing physicians or dispensing pharmacists to self-report;

Whereas such reporting is neither conducted by an objective third party nor of sufficient depth and accuracy to effectively monitor the occurrence of assisted suicide;

Whereas there is an astounding lack of transparency in the practice of assisted suicide to the extent that State health departments and other authorities admittedly have no method of knowing if it is being practiced within the bounds of State laws and have no funding or authority to make such a determination;

Whereas some State laws actively conceal assisted suicide by directing the physician to list the cause of death as the underlying condition without reference to death by suicide;

Whereas the confidential nature of end-of-life decisions makes it virtually impossible to effectively monitor a physician’s behavior to prevent abuses, making any number of safeguards insufficient;

Whereas the cost of lethal medication is far less costly than many life-saving treatments, which threatens to restrict treatment options, especially for disadvantaged and vulnerable persons, as has happened in several known cases and presumably many more unknown in which insurers have denied and/or delayed coverage for life-saving care while offering to cover assisted suicide; and

Whereas access to personal assistance services such as in-home hospice and palliative care, home health care aides, and nursing care/nursing assistance is regretfully limited and subject to long waiting lists in many areas, placing systemic pressure on patients in need of such personal assistance services to resort to assisted suicide: Now, therefore, be it

Resolved by the House of Representatives (the Senate concurring), That it is the sense of the Congress that the Federal Government should ensure that every person facing the end of their life has access to the best quality and comprehensive medical care, including palliative, in-home, or hospice care, tailored to their needs and that the Federal Government should not adopt or endorse policies or practices that support, encourage, or facilitate suicide or assisted suicide, whether by physicians or others.

Wednesday, September 27, 2017

Ever since Terri Schiavo, writing about the wrongness of removing feeding tubes from patients diagnosed with persistent unconsciousness (PVS)–we should never call them “vegetables,” a term as denigrating and dehumanizing a racial epithet–is like spitting in the wind.

But, what the heck. As mentioned above, such patients are often dehydrated to death by having their feeding tubes removed, which takes up to two weeks.

Never mind that some 40% of such diagnoses are erroneous. Never mind that some of these people may feel the agony of not eating or drinking if so misdiagnosed. Bioethics and law treat artificial nutrition and hydration as a medical treatment, and any medical treatment can be refused or withdrawn.

But what if scientists found a way to awaken such patients? That may be on the way after an unconscious patients seems to have been roused through nerve stimulation. From the Guardian story:

A 35-year-old man who had been in a persistent vegetative state (PVS) for 15 years has shown signs of consciousness after receiving a pioneering therapy involving nerve stimulation.

The treatment challenges a widely-accepted view that there is no prospect of a patient recovering consciousness if they have been in PVS for longer than 12 months.

Since sustaining severe brain injuries in a car accident, the man had been completely unaware of the world around him. But when fitted with an implant to stimulate the vagus nerve, which travels into the brain stem, the man appeared to flicker back into a state of consciousness.

He started to track objects with his eyes, began to stay awake while being read a story and his eyes opened wide in surprise when the examiner suddenly moved her face close to the patient’s. He could even respond to some simple requests, such as turning his head when asked – although this took about a minute.

This should be good news that should cause us to pause in removing feeding tubes from the unconscious as this research proceeds. (Some bioethicists even want such removals to become the standard of care, say after two years.)

But I can hear the bioethicists now–because I have read their advocacy: It is more urgent to remove the feeding tubes from the minimally conscious because they may be in horror at their impaired condition or otherwise suffering. And, in fact, people with minimal awareness are legally dehydrated in all fifty states.

Except–a study of patients in a locked-in state–the appearance of complete unconsciousness but actually aware–shows that most are “happy,” and majorities would not want euthanasia. (Scientists can now communicate with such patients.)

So, as this research proceeds, let’s care for these seriously disabled patients–both apparently unconscious and conscious–as full and equal members of the moral community, and think twice before removing sustaining treatment that can only have one result; a protracted and perhaps, painful death.

The Massachusetts Legislature is considering a measure that would allow physician-assisted suicide, but skeptics held a briefing last week foreseeing sad consequences if it passes.

“It is a widespread human desire to experience a peaceful, relatively pain-free death. But I think it would be a mistake to make physician-assisted suicide legal, especially as Americans’ access to health care is under threat of repeal,” said state Representative Denise Provost (D-Somerville). “People with disabilities, those who are poor or otherwise marginalized, could easily be pushed to choose premature death as their options narrow.”

The article then features comments by disability rights activist, Tom Wood:

One hearing attendee, Tom Wood of Salem, New Hampshire, insisted that euthanasia in no way equates with compassion.

“It is not mercy. It’s out and out premeditated murder,” said Woods, who is a member of Spectrum Boston and Mass ADAPT, both of which advocate for the disabled.

John Kelly

The article then quotes comments by John Kelly, from Second Thoughts Massachusetts.

John Kelly, director of Second Thoughts Massachusetts, which warns against a growing “better dead than disabled” mindset in the United States, said assisted suicide is a disability rights issue that threatens everyone.

“Because of misdiagnosis, abuse, insurers’ bottom line, suicidal despair, people’s guilt and coercion and abuse, these kinds of bills are very dangerous for everyone in the state. Innocent people will lose their lives if these bills become law,” Kelly said.

One briefing attendee, Brian Shea of Somerville, suggested that targeting certain people is the inevitable outcome of the proposed new law: “It is the use of the state to manage a section of the population who are poorer, who are marginalized, and who are a lot of people of color.”

Anita Cameron

Not Dead Yet responsed to the comment that "safeguards" will protect people:

Even if safeguards exist for terminally ill individuals, they argue, disabled patients represent a vulnerable demographic that could, in the future, be targeted both by a contracting health care system and by insurance companies worried about controlling costs and unwilling to pay for expensive care.

Earlier this month the American College of Physicians issued a policy statement against the legalization of assisted suicide. “This practice is problematic given the nature of the patient-physician relationship, affects trust in that relationship as well as in the profession, and fundamentally alters the medical profession’s role in society,” the organization’s position paper states.

The Washington Times reported this past May that insurance companies in states where physician-assisted suicide is legal have refused to cover expensive, life-saving treatments for patients, but have offered to help them end their lives instead.

Drugs for assisted suicide cost about $75 to $100, making them far less expensive than providing medical care.

Anita Cameron, director of minority outreach for Not Dead Yet, which opposes the measure, insists that economic pressure will help normalize euthanasia, and that in that environment the potential for abuse to the disabled community would be real.

“It is cheaper to kill us than to have us live,” says Cameron.

The article ended by explaining that assisted suicide has been debated many times in Massachusetts.

The 2017-2018 session is the eighth time a so-called “death with dignity bill” is under consideration in the Massachusetts legislature. Additionally, in 2012, the issue came before voters in the form of a ballot question. Voters rejected the measure 51 to 49 percent.

The next hearing for the House and Senate assisted suicide bills is scheduled for Tuesday, September 26 in the Joint Committee on Public Health.

If the legislature approves the bill, it will go on to Governor Charlie Baker for signature.

As of Monday morning, the governor’s office had not provided comment.

The article is based on the legislative briefing that was sponsored by Second Thoughts Massachusetts, a disabled-rights organization that opposes assisted suicide.

Tuesday, September 26, 2017

Last year on December 19, the mayor of Washington, DC, Muriel Bowser, signed into law the "Death with Dignity Act," which permits people to request and receive a lethal dose of drugs to end their lives. Congress, however, has the authority to review and reverse decisions made by the DC Council, and the House has approved a measure with a provision that would terminate the assisted-suicide law. The House bill goes to the Senate now.

"Assisted suicide is sold to us as a lie," says Schadenberg. "They sell it as about choice and autonomy which, of course, is what everybody is in favor of. But what it's actually doing is giving a doctor the right to cause your death – and it's a very, very serious situation because it's dealing with people who are at the most vulnerable time of their life."

Schadenberg says bills to legalize assisted suicide were introduced in 26 states this year and all were defeated. As recently as last week, the New York State Court of Appeals ruled there is no constitutional right to assisted suicide.

"It's not a juggernaut," says Schadenberg, "and when people look at what it's actually about, they recognize how bad it is and they actually vote to defeat it. I'm hoping that the Senate has the strength to do the same."

In Canada, assisted suicide was imposed on citizens by a ruling from the Canadian Supreme Court.

Wednesday, September 20, 2017

The New Zealand Māori Party are urging people not to vote for the Labour Party because of their stance on euthanasia and assisted suicide. The Newshub in New Zealand reported:

In a statement released by the party, Tuilagi Saipele Esera, Māori Party Candidate for Manukau East, said Labour's intention to legalise euthanasia and assisted suicide was against Christian and Pacific cultural values.

"Euthanasia and assisted suicide is a rejection of the importance and value of human life. Do not vote Labour."

Labour Party leader Jacinda Ardern has previously expressed support for ACT leader David Seymour's End of Life Choice Bill, which would give "people with a terminal illness or a grievous and irremediable medical condition the option of requesting assisted dying".

Mr Esera urged Pacific leaders and communities to "not second guess" what Labour would do if elected.

The American College of Physicians (ACP) has published an updated position on assisted suicide and yet the updated position continues to clearly oppose physician-assisted suicide while urging excellent pain and symptom management. Link to the ACP position statement.

The Position of the ACP:

The ACP affirms a professional responsibility to improve the care of dying patients and their families.

The ACP does not support the legalization of physician-assisted suicide, the practice of which raises ethical, clinical, and other concerns. The ACP and its members, including those who might lawfully participate in the practice, should ensure that all patients can rely on high-quality care through to the end of life, with prevention or relief of suffering insofar as possible, a commitment to human dignity and management of pain and other symptoms, and support for families. Physicians and patients must continue to search together for answers to the challenges posed by living with serious illness before death

The ACP conclusion:

Society's goal should be to make dying less, not more, medical. Physician-assisted suicide is neither a therapy nor a solution to difficult questions raised at the end of life. On the basis of substantive ethics, clinical practice, policy, and other concerns, the ACP does not support legalization of physician-assisted suicide. This practice is problematic given the nature of the patient–physician relationship, affects trust in that relationship as well as in the profession, and fundamentally alters the medical profession's role in society. Furthermore, the principles at stake in this debate also underlie medicine's responsibilities on other issues and the physician's duty to provide care based on clinical judgment, evidence, and ethics. Control over the manner and timing of a person's death has not been and should not be a goal of medicine. However, through high-quality care, effective communication, compassionate support, and the right resources, physicians can help patients control many aspects of how they live out life's last chapter.

The position of the ACP recognizes the importance of the patient/physician relationship and the importance of caring for and not killing patients.

Tuesday, September 19, 2017

Many euthanasia and assisted suicide proponents frame their arguments around “facts” and declarations that there is a majority of citizens who support such legislation. Yet, when you take a closer look, their “strong” basis for support is based on misconceptions about such legislation – and misconstrued facts!

Myth 1: Public polls are reliable, and a decision about assisted suicide must accord with their results.

Reality: a poll about any matter is only useful to the extent that the question asked is realistic, and those polled have some knowledge about the matter…. Is it clinically realistic to ask a question like “Are you in favour of assisted suicide if someone has uncontrollable pain, and is terminally ill?”

A reading of the 1037 submissions to the Victorian parliamentary committee shows that such scenarios have occurred in the past (before palliative care was available) but should not be the case in 2017, now that modern palliative care is available – if people will use it. Good pain control measures are now possible if used properly.

Myth 2: Pain is the main issue.

Reality: Recent research with people in Canada who requested assisted suicide shows that pain is not the main issue. The main reason given was a desire for control of personal circumstances.

This means that the “uncontrollable pain” issue has been used somewhat as a selling point, and the assertion of ‘autonomy’ is the main underlying issue. However, an assisted suicide process is not really autonomy, since others would be involved, and to exercise such choice would require a major change to medical ethics.

Myth 3: Doctors can tell you how long you have to live.

Reality: Doctors can give five-year survival rates. No doctor can tell you how long a person has to live. Such comments are guesswork. A guideline for PAS involving a 12-month prognosis is an illusion.

Myth 4: Assisted suicide would affect that individual only.

Reality: A law change affects everyone in the community. Hence there is a need to evaluate the effect of PAS law on the common good and medical practice. The fact is that in The Netherlands, and Belgium, the criteria have slipped to include not just people who appear terminally ill, but those with psychiatric illness who are physically well, and those who state they suffer in some way (but who are not assessed for any possible treatment).

Myth 5: Families are always benign and caring.

Reality: Evidence is that elder abuse is most likely from those close to a person, especially family. It is also a reality that when a person is seriously ill, many family members find it very stressful, and have quite mixed feelings about the ill person: part of you wants them to go on; part of you wants the whole experience over asap. I have experienced this myself. It makes a seriously ill person vulnerable to coercion from family to go down the assisted suicide path.

Myth 6: Likely guidelines are adequate safeguards.

Reality: The guidelines set out by the Victorian Ministerial Advisory Panel do not provide for any medical assessment of palliation at all. They do not provide for a genuinely independent medical opinion and do not attempt to detect coercion of the person. The door to elder abuse is left wide open.

Myth 7: The standard of future healthcare will not be affected.

Reality: As has become apparent overseas, healthcare economists soon realize that it is likely cheaper for the bureaucracy to offer a ‘comfort medication’ (suicide pill) than to pay for palliative care or chemotherapy. It is therefore very likely that assisted suicide legislation will distort future health care delivery – and that conclusion is drawn without even considering the expense of future dementia care.

These myths and misconceptions can have (literally) deadly consequences. Before any decisions or even debate takes place, all citizens have the right to fully understand what effects potential euthanasia and assisted suicide legislation could have, AND what other options exist.

Prematurely killing people as a means to escape pain and fear is not the answer. Instead, we can focus on making care and life better for all citizens, at all ages and for any condition.

This excellent article is written by Kenny Fries, an author who recently published “In the Province of the Gods.” Fries is writing about his explanation to a young German neurologist of the truth about how the Nazi's T4 euthanasia program killed as many as 300,000 people with disabilities. The killing techniques were developed in the Psychiatric hospitals and then used in the Nazi death camps. Fries takes the killing of people with disabilities personally:

I have a personal stake in making sure this history is remembered. In 1960, I was born missing bones in both legs. At the time, some thought I should not be allowed to live. Thankfully, my parents were not among them.

I first discovered that people with disabilities were sterilized and killed by the Nazis when I was a teenager, watching the TV mini-series “Holocaust” in 1978. But it would be years before I understood the connections between the killing of the disabled and the killing of Jews and other “undesirables,” all of whom were, in one way or another, deemed “unfit.”

Nazi euthanasia victims

Many facts about the Nazi T4 euthanasia program are not well known. Fries explains:

While he does know that approximately 300,000 disabled people were killed in T4 and its aftermath, he doesn’t know about the direct connection between T4 and the Holocaust. He doesn’t know that it was at Brandenburg, the first T4 site, where methods of mass killing were tested, that the first victims of Nazi mass killings were the disabled, and that its personnel went on to establish and run the extermination camps at Treblinka, Belzec and Sobibor.

Three years earlier, when I first arrived in Germany, I was consistently confronted with the treatment of those with disabilities under the Third Reich. But I soon realized I had to go back even farther. In the 1920s, the disabled were mistreated, sterilized, experimented on and killed in some German psychiatric institutions. In 1920, the psychiatrist Alfred Hoche and the jurist Karl Binding published their treatise, “Permitting the Destruction of Unworthy Life,” which became the blueprint for the exterminations of the disabled carried out by the Third Reich.

I am also Jewish. At the Karl Bonhoeffer psychiatric hospital in the Berlin suburb of Wittenau, where the exhibition “A Double Stigma: The Fate of Jewish Psychiatric Patients” was held, I learned about, as the exhibition title suggests, how Jewish patients were doubly stigmatized by being separated from other patients, denied pastoral care, and were cared for not at the expense of the Reich but by Jewish organizations. Jewish patients were singled out for early extermination; by December 1942, the destruction of the Jewish patient population at Wittenau was complete.

Nazi euthanasia victims

Fries explains why the history of the Nazi T4 euthanasia program important to us today:

Why is it important to know this history? We often say what happened in Nazi Germany couldn’t happen here. But some of it, like the mistreatment and sterilization of the disabled, did happen here.

A reading of Hoche and Binding’s “Permitting the Destruction of Unworthy Life” shows the similarity between what they said and what exponents of practical ethics, such as Peter Singer, say about the disabled today. As recently as 2015, Singer, talking with the radio host Aaron Klein on his show, said, “I don’t want my health insurance premiums to be higher so that infants who can experience zero quality of life can have expensive treatments.”

These philosophers talk about the drain on “resources” caused by lives lived with a disability, which eerily echoes what Hoche and Binding wrote about the “financial and moral burden” on “a person’s family, hospital, and state” caused by what they deem lives “unworthy of living.”

Many people think that these attitudes towards people with disabilities are in the past. Fries asks the question:

What kind of society do we want to be? Those of us who live with disabilities are at the forefront of the larger discussion of what constitutes a valued life. What is a life worth living? Too often, the lives of those of us who live with disabilities are not valued, and feared. At the root of this fear is misunderstanding, misrepresentation, and a lack of knowledge of disability history and, thus, disabled lives.